About 15 seconds after the call came into STARS that a young skier struck a tree and needed urgent, critical care, our helicopter was dispatched. Fifteen seconds is not the norm, but it could become more common if a new pilot project at STARS proves effective.
Dr. Gavin Greenfield was working a shift in the STARS Emergency Link Centre (ELC) when 911 communication popped up on the computer screen that a young girl sustained a head injury at a ski hill.
“I could see the information in real time, and I could tell by the first reports coming in that we should launch right away,” said Dr. Greenfield.
“Instead of waiting, we set the tones off and — boom — we prepared for dispatch. I truly don’t know how we could have been any more efficient.”
Dean Ferguson, who has worked as an emergency communications specialist in the ELC for 25 years and was on shift with Dr. Greenfield when this request came in, calls the pilot project “a game-changer” for patient care.
“The decision to launch immediately likely saved the patient five to ten minutes just in the initial transfer of information alone,” said Ferguson.
“Often, we stand by until EMS arrives, so they can provide more information from the scene, but in this case, because the consultant transport physician was in the ELC, we were in our final approach with the helicopter as EMS arrived. That’s another 30-minute time savings for the patient.”
Dr. Greenfield, or any of the other STARS transport physicians, is typically not at a base while on call. Instead, when a communications specialist in the ELC receives a request for STARS, he or she would relay the message to the on-call transport physician and the air medical crew (AMC) on shift. The AMC can choose to launch on their own without approval from the transport physician. If AMC choose to not launch, that is when the doctor is brought in to make the final decision. The doctor would then provide guidance to the crew via phone conference to decide whether to dispatch the helicopter.
This pilot project, launched in January and set to wrap up in June, sees transport physicians inside the ELC three days a week for an eight-hour shift, saving time in the transfer of information, said Dr. Jamin Mulvey, medical director at the Calgary base.
“Sometimes the transport physicians aren’t immediately available, or there is a gap in oversight,” said Dr. Jamin, who first gained experience working within similar systems in Australia and the United Kingdom and pitched the idea to the organization.
“This is an opportunity to improve our access to patient medical records, provide real-time accuracy and support, and ultimately foster better integration of the doctors and the ELC,” said Dr. Mulvey.
So far, the project has been effective at getting our crews to patients more quickly as well as preventing us from launching for calls in which we may not ultimately be required. All of this saves time, money and fatigue on the crews.
Doctors Mulvey and Greenfield have already seen benefits for patients facing critical medical incidents, such as heart attacks and strokes, in which patients require early intervention.
“In true time-dependant missions where minutes matter for patient outcomes, we are seeing how these real-time decisions can make a difference,” said Greenfield. “In case of a brain bleed, for instance, where the patient needs surgery to evacuate the blood and save the brain, shaving minutes off their time to tertiary care – and ultimately the operating room – can make a difference. If the only way to get the bleeding to stop is to get the patient to tertiary care, these few minutes really do matter.”
Not only can STARS crews get to the patient and begin providing medical care more quickly, we can also save time on the back end, by making arrangements at receiving hospitals for patients who need to attend a cath lab, or see a neurosurgeon, added Ferguson.
“We were fast and efficient before, but this project is a game-changer,” he said.
The pilot project isn’t only enhancing patient care and preserving resources, an unexpected benefit is increased teamwork and integration between the staff in the ELC and the transport physicians.
“So far it’s been awesome. Not only are we getting out of the gates and to the patients faster, but we are also learning from each other and working together to be more efficient and effective. We are all benefitting from the face-to-face, real-time interaction,” said Dr. Mulvey.